Medical Education
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Sunday, 11 May 2014
Tuesday, 6 May 2014
Solutions
•Definitions
•A Solution is a homogeneous mixture of two or
more substances
OR
•A solution is a homogeneous mixture of solute and solvent
OR
•A solution is a homogeneous mixture of solute and solvent
OR
A solution is a homogeneous mixture of two substances but consisting of one phase.
•Homogeneity: something evenly distributed
•Heterogeneity: something not distributed evenly in space; a clump or cluster.
•A Solute is dissolved in a Solvent.
–solute is the substance being dissolved
–solvent is the liquid in which the solute is
dissolved–an aqueous solution has water as
solvent
•Binary solution: A homogeneous mixture consisting of one phase and containing only two components i.e. one solute and one solvent e.g. Solution of NaCl in water.
•Dilute Solutions:
A solution containing relatively small quantity of solute as compared with the amount of solvent.
•Concentrated Solution: A solution containing large amount of solute in the solution than that in dilute solution.
•Un-saturated solution: a solution in which more solute can be dissolved at a given temperature is called as an unsaturated solution.
•A Saturated solution is one where the concentration is at a maximum - no more solute is able to dissolve at a given temperature.
–A saturated solution represents an equilibrium: the
rate of dissolving is equal to the rate of crystallization. The salt
continues to dissolve, but crystallizes at the same rate or under these
condition the number of molecules leaving the solute is equal to the number of
molecule returning to the solid phase i.e. solute.
•Types of Solutions: Based on physical states of solute and solvent:
• BASED ON PARTICLE SIZE:•Solution systems or dispersed systems are those system in which one substance ( i.e. solute) is dispersed through an other phase ( i.e. solvent) called continuous phase. So the solute is called dispersed phase or dispersoid and solvent as solvent as continuous phase
•Solutions may be categorized on the basis of dispersion as follows:
•Ultra filtration is a separation process using
membranes with a pore sizes in the range of 0.1 to 0.001 micron.
Typically, ultra filtration will remove high molecular weight substances,
colloidal materials and organic polymeric molecules. Low molecular weight
organics and ions such as sodium, calcium, magnesium and sulfates are not
removed.
Vitamins
·
Fat soluble Vitamins
ü
Vitamin A (Retinol)
ü
Vitamin D (Calciferol)
ü
Vitamin E (Tocopherol)
ü
Vitamin K
·
Water soluble Vitamin
ü
Vitamin C (Ascorbic acid)
ü
Niacin
ü
Folic acid
ü
pantothenic acid
ü
Lipoic acid
ü
Vitamin B complex group
molecules
§
Vitamin B1(Thiamin)
§
Vitamin B2(Riboflavin)
§
Vitamin B3(Pyridoxin)
§
Vitamin B4(Cyanocobalamine)
·
Comparison of two major types of vitamin
Properties
|
Fat soluble vitamins
|
Water soluble vitamins
|
Soluble in fat
|
Soluble
|
insoluble
|
Soluble in water
|
Insoluble
|
soluble
|
Absorption
|
Along lipids
require bile salts
|
Absorption
is simple
|
Carrier proteins
|
Present
|
No carrier
protein is present
|
Storage
|
Stored in
liver
|
No
appreciable storage
|
Excretion
|
Not excreted
|
Excreted
|
Deficiency
|
Manifests
only when stores are depleted
|
Manifests
rapidly as no storage
|
Treatment of deficiency
|
Single large
doses may present deficiency
|
Regular
dietary supplements are required
|
Major vitamins
|
A,D,E &
K
|
B & C
|
Vitamin A
Chemistry:
Compounds of vitamin A activity
referred to as pterinoids. They are poly isoprenopid compounds with beta-ionone
ring or trimethylcyclohexenyl ring compounds.
Precursors of provitamin of
vitamin A beta-carotene give rise to two beta-ionone rings connected by poly
prenoid or hydrocarbon chain.
Dietary Sources:
Food of animal origin is retinyl
esters.
Among Diary sources i.e. butter,
milk & cheese. Highest concentration is present in the liver oils of
certain species of fish e.g. shark, cod etc. Livers of fresh water fish
contains Vitamin A2
It is also found in deep green,
yellow orange fruits & vegetables e.g. carrots and broocoli, kale,
pumpkins, sweet potatoes, peach, apricots etc. Recently “spirulina” species of
algae are found to be good sources.
Properties:
All yellow crystals of Vitamin A are almost odorless or fish like odor. They have melting point of about 63C0 to 64C0.They are soluble in alcohol, fixed oils, organic solvents i.e. ether, chloroform etc.
They are stored in air tight
containers protected from light. They are made stable by the use of
antioxidants from light and oxygen.
Daily requirement:
§ Children……….400 to 600 mg/day
§ Men……………..750 to 1000 mg/day
§ Women……….750 mg/day
Hypervitaminosis:
It is characterized by failure,
irritability, anorexia, and loss of weight, vomiting & other GIT disorders.
Fever, skin changes, alopecia dry hairs, cracking and bleeding of lips, anemia,
headache, pain in bones and joints.
Deficiency:
The major problems areNight
blindness, Xerothalmia&keratomalaria.
1. Small triangular patches on the inner outside of cornea covered
by a material like formed termed as bitots spots.
2. When xerothalmia persists for a drug for a long period of time
it progresses to keratomalaria
(softening of cornea) so it becomes dry, rough and scaly.
3. Retardation of growth accompanied by defects of skull bones on
CNS may produce nerve degeneration and paralysis.
4. Its suitable quantity is required for normal activity of mitochondria
and deficiency interferes with oxidative phosphorylation.
Vitamin K
It is also known as Antihaemorragicfactor.It has basically two types;
1.
Vitamin K1 (mainly obtained from Alfalfa leaves)
2.
Vitamin K2 (mainly obtained from fish meals and intutinal
bacterial flora)
Chemistry:
These are derivatives of phytal
chains. First two are natural while other two are synthetic types of Vitamin K.
1. Vitamin K1 (Phyeloquinone)
2. Vitamin K2 (Farnoquinone)
3. Vitamin K3 (Manadione)
4. Vitamin K4 (Menadial)
Sources:
It is mainly obtained from green
fresh leafy vegetables e.g. Alfalfa, cauliflower, cabbage, tomatoes, soya beans
etc.
An intestinal microorganism
possesses high Antihaemorragic concentration which may be 11 to 38 times as
active as alfalfa. The names of the microorganisms are Bacillus cereus,
Bacillus subtilis, Bacillus mycoids, Bacteriaumproteus, mycobacterium
tuberculosis, Sarcinalutea and Staphylococcus aureus etc.
Daily requirement:
50 to 100 mg/day should be
available in normal diet.
Deficiency:
Prolong use of broad spectrum antibodies
and sulfa drugs lead to fall of prothrombin level in plasma an abnormal long
coagulations times and tendency to spontaneous haemorrage.
Functions:
1. It is very important to maintain adequate plasma level of the
protein prothrombin (factor ӏӏ) and three other essential clotting factors i.e.
proconvertin (factor VII), autoprothrombin (factor IX) andstuart power factor
(factor X).
2. During clotting the circulating thrombin i.e. required for the
production of thrombin which converts fbrin into fibrinogen.
3. It is involved in the production of two anticoagulant proteins
as proteins C & S.
4. It is administerded with bile in pre-operative and
post-operative jaundiced patients to main tain normal protein levelk in blood.
5. It is necessary cofactor in oxidative phosphorylation being
associated with mitochondrial lipids. The normal process of oxidative process
of phosphorylation is released when vitamin K is added to them.
Hypervitaminosis:
Administration of large
quantities of medicine may result in toxicity as hemolysis, hyperbilirubinemia
and brain damage.
Vitamin E
Chemistry:
It was discovered in 1936. It is
also known as antisterility factor or tocopherol. It is greenish yellow odorless,
viscous, oily liquid, free soluble in organic solvents and fixed oils.
Different degrees of
antisterility factors;
§ Processes antioxidant purposes
§ Include a group of 8 compounds
§ Among these α, β, γ and δ are important.
Basic structure of tocopherol
shows that;
§ Chromane ring i.e. tocol
§ Trimethyltridecyl i.e. saturated hydrocarbon side chain)
Methyl substituted tocol
derivatives;
1. α-tocopherol
(5,7,8-trimethyl tocol)
2. β-tocopherol
(5,8-dimethyl tocol)
3. γ-tocopherol
(7,8-dimethyl tocol)
4. δ-tocopherol (8-methyl
tocol)
Sources:
Tocopherols are abundant in wheat
germs, rice germs, corn germs, lettuce, soyas, cotton seed oil. There is an
evidence that some green leafy vegetables and rose hips contains more vitamin E
than wheat germ.
Biochemical role of Vitamin E:
1. It is a powerful natural antioxidant.
2. Free radicals are greatly generated in living systems products
of oxidative detoriation of poly unsaturated fat would attack biomembranes,
while vitamin E converts free radicals into non harmful form.
3. Protects RBC’s from hemolysis by preventing the peroxidation. It
keeps the structural and functional integrity of all cells.
4. It shows down aging process which is due to cumulative effects
of free radicals.
5. It ppt’s in nucleic acid metabolism b/c of tocopherols are component
of cytochrome reductase segment of terminal respiratory chain.
6. It has a role in the regulation of protein synthesis.
7. It has been investigated to have an effect on enzymes e.g.
creatine kinase and liver Xanthine oxidase.
Requirement:
·
Males 10mg/day
·
Females 08mg/day
·
During pregnancy its
requirement is about 10mg/day. While during lactation 12mg/day.
Deficiency:
Human deficiency has not been
reported.
In volunteers the vitamin E
deficiency produced increase fragility of RBC’s, muscular weakness and creatine
urea.
Hypervitaminosis:
It is observed only in large
doses in animal causes reversible symptoms as skeletal muscle weakness, GIT
disorders and disturbances of reproductive functions.
Vitamin B1
It consists of Thiazole ring and
pyridine ring. It is also called Thiamin.
Sources:
Ø Richest sources include dried yeast (03 to 06 mg/100g)
Ø Rice polishing (2 to 3 mg), wheat germ (1.5 to 2.5 mg)
Ø Whole cereals (0.4 to 0.1 mg), while in leguminous oils, seed
and meat (0.3 to 0.4 mg)
Requirement:
·
Total concentration of
thiamin in the body of an adult is in the range of 20 to 25 mg.
·
Its daily requirement is 1
to 1.5 mg/day.
Physiological role of thiamin:
1. The co-enzyme form is thiamin pyrophosphate (TPP) it is used in
oxidative decarboxylation of alpha-ketoacids e.g. pyruvate carboxylase.
2. A component of pyruvate dehydrogenase (an enzyme) that catalyze
the breakdown of the pyruvate to acetyl CoA and CO2.
3. Biochemical reactions require TPP in the decarboxylation of
alpha-ketoglutarates to succinyl CoA and CO2.
4. Second group of enzymes that use TPP as coenzyme as Transketolase
in the Hexose monophosphate shunt pathway of glucose.
5. The main role of carbohydrate metabolism so its requirement is
increased along with higher intake of carbohydrate.
6. In patients on parenteral nutrition who receive all their
calories in the form of glucose than thiamin requirements are high.
Deficiency
& Manifestations:
It results in severe
Neuromuscular syndromes i.e. beriberi which may be classified into many types;
§ Dry beriberi
§ Wet beriberi
§ Acute beriberi
The signs and symptoms of
clinical beriberi are loss of strength, fatigue, headache, dizziness,
nervousness, loss of appetite, dyspepsia etc.
Deficiency:
Other forms of thiamin deficiency
which are seen clinically are alcoholic poly neuritis with motar and sensory
defects in chronic in alcoholics. Alcohol utilization needs large doses of
thiamin. At the same time alcoholics take less nutritive food leading to
deficiency.
Vitamin B2
Chemistry:
It is also called Riboflavin. It
is an orange yellow compound. Chemically it contains o-ribitol (ribose alcohol)
attached to heterocyclic parent ring structure that is dimethyl isoallorazine
or simply it is 7, 8-dimethyl-10-isoallorazine.
Dietary sources:
Rich sources are liver, dried
yeast, egg, whole milk and milk powder. Good sources are fish, whole cereals
and green leafy vegetables.
Requirement:
A daily dietary intake of about 1.1 to 1.7
mg/day is required. Increased quantity is needed during pregnancy and
lactation.
Toxicity:
It is not reported but large
doses result in light yellow de-coloration of urin.
Functions:
1. Riboflavin make two co-enzymes B2 monophosphate
usually called flavin mononucleotide and other is flavin dinucleotide.
2. FMN is the co-enzyme of cytochrome C reductase, L-aminoacid
dehydrogenase etc.
3. FAD is the co-enzyme of Xanthine oxidase, liver, aldehyde
oxidize and acyl CoA dehydrogenase.
4. The formation of FMN and FAD is increased by the thyroid hormone
and adrenal steroids. The enzyme containing riboflavin are called flavor
protein, they carry out redox reactions.
Vitamin B6
Chemistry:
Pyridoxine is one of the compounds that can be called vitamin B6,
along with pyridoxal and pyridoxamine. It differs from pyridoxamine by the
substituent at the '4' position. Its hydrochloride salt pyridoxine
hydrochloride is often used. They mostly exhibit vitamin activity
inter-convertible in-vivo.
Source:
Vitamin B6 is
widely distributed in foods in both its free and bound forms. Good sources
include meats, whole grain products, vegetables, nuts and bananas.
Requirement:
·
Males……….1.3 mg/day
·
Females……1.5 mg/day
Requirement is increased during pregnancy and
lactation.
Functions:
·
The primary role of vitamin B6 is to act as a coenzyme to many other
enzymes in the body that are involved in metabolism. This role is performed by
the active form, pyridoxal phosphate.
Vitamin B6 is involved in the following metabolic
processes:
i.
Amino acid, glucose
and lipid metabolism
ii.
Neurotransmitter
synthesis
iii.
Histamine synthesis
iv.
Hemoglobin synthesis
and function
v.
Gene expression
·
It involves in the lipid metabolism as well.
·
It also causes Gluconeogenesis.
Deficiency:
The classic clinical syndrome for B6 deficiency is a seborrhoeic dermatitis-like eruption, atrophic glossitis with ulceration, angular cheilitis, conjunctivitis, intertrigo, and neurologic symptoms
ofsomnolence, confusion, and neuropathy.
Toxicity:
Adverse effects have only been documented
from vitamin B6 supplements
and never from food sources.
Powders
Powders
Powders are solid
dosage form of medicaments which are made for internal and external purposes.
They are available in amorphous and crystalline form. Drugs are prepared in
different forms and shapes but many of them are prepared by using powder in one
way or the other incompatibility (the quality of being discordant).
Advantages and disadvantages of powder:
The various merits and demerits
of powders are discussed below;
Advantages:
1. Many of drugs are available in powder form it become convenient
for physician to prescribe specific amount of medicaments.
2. Powders are less in compatible than liquids. Large quantities of
bulky drugs which are difficult to administer can be easily taken with the help
of liquid.
3. They are easier to carry than liquids.
4. They are more stable than liquids.
5. Chemical reactions take place more easily in liquids than
powders in atmospheric condition.
6. Small particles of powders produce more rapid dissolution in
body fluids than other dosage form.
7. They are more economical for extemporaneous preparations.
8. They are convenient for pediatric (child) and geriatric patients
(old aged people).
Disadvantages:
1. Drugs which deteriorate on exposure to atmospheric conditions
are not suitable for powders.
2. Bitter, nauseous, corrosive and unpalatable drugs can’t be
dispensed in powder form.
3. Deliquescent and hygroscopic drugs can’t be dispensed in powder
form because they absorb moisture.
4. Volatile drugs are not suitable for powder form because they
lose their efficacy.
·
Simple and compound powders
for internal use.
·
Granular and effervescent
powders for internal use.
·
Bulk powders for external
use.
·
Dusting powders,
insufflations (used to insert into different body cavities) and tooth powders.
Practice size analysis:
Before the use of powders and
other solid materials in pharmaceutical products characterized to determine
their physical and chemical properties. It includes morphology, purity,
solubility, stability, particle size and impurity.
The particles of pharmaceutical
powders may be range from extremely coarse about 10mm in diameter to extremely
fine approaching to colloidal dimension of micron or less. To characterized the
particle size in USP;
Ø Very
coarse:Powders of vegetable and animal drugs are officially
defined as very coarse. All particles pass through the 8 sieve and not more
than 20% through a no. 50 sieve
Ø Coarse:All
particles pass through a number 20 sieve and not more than 40% through sieve
number 60.
Ø Moderately
coarse:All particles pass through a number 40 sieve and not more
than 40% through sieve number 80.
Ø Fine: All
particles pass through a number 60 sieve and not more than 40% through sieve
number 100.
Ø Very fine:All
particles pass through a number 80 sieve, there is no limit to to greater
fineness.
Blending powers:
These are formed when two or more
than two powdered substances are to be combined to form a uniform mixture. It
is best to reduce the particle size of each powder before weighing and
blending.Depending upon the nature of ingredients amount of powders and
equipment, powders may be blended by;
Ø Spatulation:it
involves the using spatula on white papers or slides to decrease the particle
size.
Ø Trituration:It includes
the reduction of particle size on small scale by using pestle and mortar
i.e. levigation& pulverization.
Ø Sifting:For
sifting process we require sifters i.e. any containers in which two substances
are used. It is not used for the substances which produce therapeutic effects
in small quantity i.e. potent drugs. In involves the usage of different types
of machines for example; V-type, M-type and ribbon type machines.
Ø Tumbling:Another
method of powder mixture is tumbling. In this process powder is mixed in closed
chamber by using motorized chamber for example H-type, Ribbon type or U-mixture.
H-type total capacity is calculated. The 30% of the volume of total substance
is reduced.
Ø Medicated powders:
Some medicated powders are
intended to be used internally and externally. Some powders are taken
internally with the help of water. Some powders are inhaled for local or
systemic purposes; other dry powders are commercially packaged for constitution
with liquid solvent and vehicle. Some used for parenteral and others are used
as vaginal douches.
Ø Aerosol powders:
Some medicated powders are
administered by inhalations with the aid of dry powder inhalers which deliver
micronized particles of medication in metered quantities. Most of these
products are used in the treatment of Asthma and bronchial disorders, deep
lungs for this purpose particle size must be 1 to 6 microns.
Bulk and divided powders:
Ø Divided powders:
After the powder has been
properly blended using a geometric dilution method for potent substances. It
may be divided into individuals closing units depending on the amounts of
medicament taken as single dose.
It includes Bulk powders,
antacids and laxatives douches powders and medicated powders for external use.
General methods of preparations of Powders
Since there is a little
unavoidable loss of powders during weighing and mixing because some powder will
adhere to spatula, pestle and mortar, therefore calculation for one extra powder
then required. But if by calculating for extra powder an awkward fraction of
weight is involved then a suitable no. of extra powder may be calculated. The
dispensing balance is not so sensitive than the quantities less than 2 grains
or 130mg must be triturate with a with a suitable inert diluent so that the
quantities are made weighable on dispensing balance.
Generally lactose is used as
diluent because it is colorless, soluble and compatible with majority of drugs.
Mix all ingredients in ascending order of their weighs and mix thoroughly so
that a homogenous mixture is formed.
Weight out required no. of powder
and wrap in papers. The volatile substance and hygroscopic powders required to
be double wrapped. The inner wrapped of which should be of wax paper to prevent
volatilization and absorption of moisture.
Powders require special consideration:
The considerations which should
be kept under observation for powders are written below;
1.
Hygroscopic and delinquent:
The substances which absorb
moisture from the atmosphere are not suitable for dispensing in powder papers
because they absorb moisture and promote the chemical degradation of drugs. In
case of effervescent preparation the acid may completely react with sodium
bicarbonate (NaHCO3), ammonium chloride (NH4Cl), sodium
bromide (NaBr), sodium iodide (NaI) and talc.
Hygroscopic powders are usually
supplied in granular form in order to expose less surface area to atmosphere.
They should not be finely powdered. They should be doubly wrapped. In humid
weather Aluminum foil or plastic is used.
2.
Eutectic mixtures:
When two or more than or
substances are mixed together they tend to liquefy due to the formulation of
new compound which has a lower melting point than room temperature for example
Acetamide, Methnol, thymol, phencetin, camphor, aspirin, phenol etc.
They may be dispensed as a
separate set of powders. They may be incorporated in powder by adding invert absorbent
like light magnesium carbonate (MgCO3) or magnesium oxide (MgO).
3.
Efflorescent powders:
These are crystalline substances
that liberate water of crystallization completely or partially due to change in
relative humidity or during trituration, causing the powder to become wet or
liquefy. This difficulty may be overcome by using either corresponding
anhydrous salt or inert substances mixed.
Granular powders
Sometimes it is difficult to
present solid medicaments and large suitable forms. The tablets and capsules
cannot be prescribed because a large number of them will be required to take a
single dose which is not feasible liquids cannot be prepared because of
stability problems.Choice remains to powders but bitter nauseous and unpleasant
powders are different to dispense as such. These powders are prepared in the
form of granules.
Ø Vegetable powders:
Contain volatile oils should not
be subjected to heavy grinding in the mortar. When it is necessary to powder
them lightly in the mortar to prevent the loss of volatiles oils present in
them. In dispensing vegetable powders and other volatile substances they must
be doubly wrapped inner wrapper of which should be of wax paper.
Ø Effervescent granules:
These are specially prepared
solid dosage form of medicament meant for internal use. They usually contain a
soluble medicinal agent mixed with citric acid, tartaric acid, sodium
bicarbonate.
Method of preparations of Granules
Granules are prepared by several
of the following methods;
§ Heat method
§ Wet method
Heat method:
A large porcelain or stainless
steel evaporating dish is placed over water bath which is being heated to
boiling point and must ensure that the evaporating dis is not when the powder
are added to it. Failing to do so will not provide sufficient water needed for
granulation which will be liberated by citric acid on heating.
Wet method:
In this method the mixed
ingredients are moistened with suitable liquid (for which alcohol is most
suitable) in dish in which alcohol is added in small portion with continuous
stirring until a coherent mass is formed. The mass is then passed through a no.
6 sieve and the granules are dried on 590C temperature not exceeding
600C.The dried granules are again passed through the sieve break the
lumps which may have formed during drying. They are packed in wide mouth air
tight containers.
Ø Bulk powders:
They are supplied in bulk
quantities and the patient measured the dose according to need. The bulk
powders are meant for internal use is supplied in wide mouthed containers in
which a tea spoon can be entered easy removal of the contents. Only the
non-potent substances are supplied as bulk powders. Example: Antacids,
laxatives etc.
Bulk powders meant for external
use like antiseptic and dusting powders are supplied in card board glass or
plastic containers, which are often designed for specific method of
application.
Ø Dusting powders:
These are meant for external
appropriate to the skin for antiseptic, antipruritic, antiperspirant,
absorbent, protective and lubricant. The powder must be homogenous and in a
very fine state of subdivision to enhance the effectiveness and minimize local
irritation.
Ø Insufflations:
These are finely divided powders
meant for the introduction into body cavities such as ear, nose, vagina, and
tooth sockets with the help of an apparatus known as insuff.
Ø Snuffs:
Snuffs are finely divided solid
dosage form of medicaments which are inhaled into nostrils for their
antiseptic, decongestion or bronchodilators action. Snuffs should be dispensed
in flat metal boxes.
Ø Dentifrices:
Dentifrices are the substances
which are generally used with the help of tooth brush for cleaning the surface
of teeth.
Ø Explosive powders:
When an oxidizing agent and a
reducing agent are triturated in mortar then are changes of explosion which may
lead of serious consequences, such substances are referred to as explosive
powders.
Ø Potent drugs:
Substance having a maximum dose
of less than are grain and poisonous substance should be regarded as potent
substances. Small quantities of drugs should not be weighed on dispensing
balance. The best method to prepare potent drugs is trituration.
Ø Cachets:
Cachets are classical dosage
form. Cachets are the solid unit dosage form of medicaments in which the drug
is enclosed in a tasteless sheet made by pouring a mixture of rice flour and
water between not polished revolving cylinders since flour and water mixture
treat easy digestible, disintegrate in stomach.
Advantages of Cachets:
1. They are easy to prepare because no complicated machinery is
required.
2. Drugs can be extemporaneously and quickly dispensed in cachets.
3. Comparatively large dosage of drug can be dispensed because one
they have been softened by dipping in water even a large size can swallowed
easily.
4. They quickly disintegrate in stomach.
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